ABSTRACT
Urinary Tract Infections caused by Escherichia coli were investigated for infectivity patterns, trends in sensitivity to fluoroquinolones, multi-fluoroquinolone resistant pattern and the fluoroquinolones’ inter-activities relation. 1590 patients (785/805 male/female) with clinical symptoms suggestive of UTI and confirmed with microbiological assay of the mid-stream of early morning urine specimens were surveyed. Isolated pathogens were cultured and sensitivity tests were performed. UTI cases increased by 17.7% between 2005 and 2009 with Escherichia coli accounting for 41% and showing an increase from 5.7% in 2005 to 28.0% in 2009 and a significant correlation (P<0.05). E. coli-UTIs were higher in females (56.6%) than males (43.4%). Pathogen’s susceptibility to agents varied but the activities of ciprofloxacin, ofloxacin, pefloxacin and nalidixic acid against E. coli recorded significant yearly decrease (P<0.05). The overall susceptibilities of E. coli were 71%, 58%, 48%, 34% and 15% for ofloxacin, ciprofloxacin, pefloxacin, norfloxacin and nalidixic acid respectively. About 35% of ciprofloxacin-resistant E. coli indicated sensitivity to ofloxacin whereas only 20% was the converse. Multifluoroquinolones- resistant cases (282, 43.6%) were observed in E. coli which increased from 30.2% in 2006 to 57.5% in 2009. The study observed a rapid and progressive loss of activities of quinolones, increasing multifluoroquinolone- resistant, high resistance rates and poor inter-activities relations between the fluoroquinolones against E. coli in the region.
ABSTRACT
Blood-stream pathogens were investigated between 2005 and 2009 in 262 patients with septicaemia in Maiduguri Metropolis, Nigeria to evaluate trends in fluoroquinolones activities against them. Blood samples were cultured in an enriched nutrient agar while susceptibilities tests were performed using the disc diffusion techniques.Staphylococcus aureus, the predominant pathogen accounted for 57.6% and peaking in 2007 with 26.5%. Salmonella spp (overall: 20.2%) infectivity increased from 2006-2008 by 15% but Klebsiella bacteraemia (14.9%) decreased by 20.7% from 2006-2008. Bacteraemia caused by Escherichia coli (7.3%) was the least. The S. aureus sensitivity to ciprofloxacin decreased by 25% between 2005 and 2007 while ofloxacin steady decrease from 2005 to 2008 by 33% showed significant correlation (P<0.05). Ciprofloxacin activities against norfloxacin-resistant and pefloxacin-resistant S. aureus (74.5% and 75% respectively) are both significantly different (P<0.005) from ofloxacin (27.7% and 37.5% respectively) but 92%, 81% and 78% of nalidixic acid-resistant Klebsiella spp are sensitive to ciprofloxacin, ofloxacin and pefloxacin respectively. The ofloxacin’s activities against E. coli were superior to ciprofloxacin with 50%, 69% and 94% of nalidixic acid-resistant E. coli being sensitive to pefloxacin, ciprofloxacin and ofloxacin respectively. However all ciprofloxacin-resistant E. coli are ofloxacin-sensitive. The study found occurrence of continuous and significant loss in activities of most fluoroquinolones against S. aureus and E. coli but while ciprofloxacin indicated high activities against S. aureus and Klebsiella bacteraemia, ofloxacin was superior against E. coli and Salmonella bacteaemia than other agents.